Crucial anatomy and technical cues for laparoscopic transabdominal preperitoneal repair: Advanced manipulation for groin hernias in adults

Figure 11 Complete preservation of the vas deferens and gonadal vessels. A: Surgical procedure during dissection around the vas deferens (VD) and gonadal vessels. Familiarity with the important structures should be required. B and C: The VD and gonadal vessels should be completely preserved without any subtle damage. D: The VD and gonadal vessels are sharply dissected from the peritoneum without use of electric cautery or a coagulating scalpel, under an adequate overhead view. EIA: External iliac artery; EIV: External iliac vein; IIR: Indirect inguinal ring; VD: Vas deferens.